Modifications in family centered developmental care and in neonatal intensive care during the COVID-19 pandemic in a hospital in Spain: A qualitative study.

INTRODUCTION: Family centered developmental care (FCDC) are a philosophy of care in the neonatal care units (NICU), based on the control of sensory stimulation the adequate position and of newborn and the family involvement of cares. Nursing staff are the main providers of this care. Sanitary measure to control of the COVID-19, such as the use of masks, isolation of positive cases and capacity limit, conditioned the implementation of FCDC. OBJECTIVES: To understand the meaning of the experience of the nursing staff of a neonatal intensive care unit (NICU) on the implementation of the FCDC, under the sanitary measures imposed for the containment of COVID-19. METHODS: A qualitative study was conducted from the descriptive phenomenological paradigm in which NICU nurses were recruited. The qualitative data collection was carried out through open-ended and semi-structured interviews. These were analyzed respectively through a preliminary narrative analysis and a thematic analysis of the informant nurses' narratives and discourses. RESULTS: Three open-ended and 7 semi-structured interviews were conducted from which three main topics emerged: 1) changes in the FCDC derived from the sanitary restrictions implemented for the containment of COVID-19; 2) changes in interpersonal relationships in the context of a pandemic, and 3) transition to normality. CONCLUSIONS: The nurses of NICU perceived changes in the implementation of the FCDC due to the containment of COVID-19, that modified the relationship with the parents of NB, accelerating their training as caregivers, and involved the implementation of new measures such as video calls.

Programa de entrenamiento basado en TeamSTEPPS® mediante simulación clínica en profesionales de cuidados intensivos: un estudio con metodología mixta / TeamSTEPPS®-based clinical simulation training program for critical care professionals: A mixed-methodology study

Introducción: El programa Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) ha demostrado mejorar el trabajo interprofesional entre los profesionales sanitarios mejorando el trabajo en equipo. Se formó a profesionales de cuidados intensivos en esta metodología mediante el Curso «Instructor/a en simulación: Mejorando el Trabajo en Equipo a Través de TeamSTEPPS®». Objetivos: Analizar el desempeño del trabajo en equipo y las buenas prácticas en simulación de los profesionales de cuidados intensivos asistentes al curso y explorar sus percepciones sobre la experiencia formativa llevada a cabo durante el mismo. Métodos: Se llevó a cabo un estudio descriptivo transversal y fenomenológico mediante una metodología mixta. Se aplicaron a los 18 asistentes al curso los cuestionarios «TeamSTEPPS™ 2.0 Team Performance Observation Tool» para evaluar el desempeño del trabajo en equipo y «Educational Practices Questionnaire» para las buenas prácticas en simulación tras los escenarios simulados. Posteriormente se realizó una entrevista grupal a través de un grupo focal a ocho asistentes mediante la plataforma de videoconferencias Zoom™. Se realizó un análisis temático y de contenido de los discursos desde el paradigma interpretativo. Los datos cuantitativos y cualitativos se analizaron mediante los programas IBM SPSS Statistics™ 27.0 y MAXQDA Analytics Pro™, respectivamente. Resultados: Tanto el nivel de desempeño del trabajo en equipo (media = 96,25; DT = 8.257) como las buenas prácticas en simulación (media = 75; DT = 1.632) tras los escenarios simulados fueron adecuados. Se identificaron los siguientes temas principales: satisfacción con la metodología TeamSTEPPS®, utilidad de la metodología, barreras de implementación de la misma y habilidades no técnicas mejoradas a través del TeamSTEPPS®. Conclusiones: La metodología TeamSTEPPS® puede ser una buena estrategia de educación interprofesional para la mejora de la comunicación el...(AU)

Introduction: The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) programme has been shown to improve interprofessional work among healthcare professionals by enhancing teamwork. Intensive care professionals were trained in this methodology through the course «Simulation Trainer: Improving Teamwork through TeamSTEPPS®». Objectives: To analyse the teamwork performance and good practice in simulation of the intensive care professionals attending the course and to explore their perceptions of the training experience carried out during the course. Methods: A cross-sectional descriptive and phenomenological study was carried out using a mixed methodology. The 18 course participants were administered the questionnaires «TeamSTEPPS™ 2.0 Team Performance Observation Tool» to evaluate teamwork performance and «Educational Practices Questionnaire» for good practices in simulation after the simulated scenarios. Subsequently, a group interview was conducted through a focus group with 8 attendees using the Zoom™ videoconferencing platform. A thematic and content analysis of the discourses was carried out using the interpretative paradigm. Quantitative and qualitative data were analysed using IBM SPSS Statistics™ 27.0 and MAXQDA Analytics Pro™, respectively. Results: Both the level of teamwork performance (mean = 96.25; SD = 8.257) and good practice in simulation (mean = 75; SD = 1.632) following the simulated scenarios were adequate. The following main themes were identified: satisfaction with the TeamSTEPPS® methodology, usefulness of the methodology, barriers to methodology implementation and non-technical skills improved through TeamSTEPPS®. Conclusions: TeamSTEPPS® methodology can be a good interprofessional education strategy for the improvement of communication and teamwork in intensive care professionals, both at the care level (through on-site simulation strategies)...(AU)

TeamSTEPPS®-based clinical simulation training program for critical care professionals: A mixed-methodology study.

INTRODUCTION: The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) programme has been shown to improve interprofessional work among healthcare professionals by enhancing teamwork. Intensive care professionals were trained in this methodology through the course "Simulation Trainer: Improving Teamwork through TeamSTEPPS®". OBJECTIVES: To analyse the teamwork performance and good practice in simulation of the intensive care professionals attending the course and to explore their perceptions of the training experience carried out during the course. METHODS: A cross-sectional descriptive and phenomenological study was carried out using a mixed methodology. The 18 course participants were administered the questionnaires "TeamSTEPPS™ 2.0 Team Performance Observation Tool" to evaluate teamwork performance and "Educational Practices Questionnaire" for good practices in simulation after the simulated scenarios. Subsequently, a group interview was conducted through a focus group with 8 attendees using the Zoom™ videoconferencing platform. A thematic and content analysis of the discourses was carried out using the interpretative paradigm. Quantitative and qualitative data were analysed using IBM SPSS Statistics™ 27.0 and MAXQDA Analytics Pro™ respectively. RESULTS: Both the level of teamwork performance (mean = 96.25; SD = 8.257) and good practice in simulation (mean = 75; SD = 1.632) following the simulated scenarios were adequate. The following main themes were identified: satisfaction with the TeamSTEPPS® methodology, usefulness of the methodology, barriers to methodology implementation and non-technical skills improved through TeamSTEPPS®. CONCLUSIONS: TeamSTEPPS® methodology can be a good interprofessional education strategy for the improvement of communication and teamwork in intensive care professionals, both at the care level (through on-site simulation strategies) and at the teaching level (through its inclusion in the students' curriculum).

Síndrome de burnout en los profesionales de cuidados intensivos: relaciones con la salud y el bienestar / Burnout syndrome in intensive care professionals: relationships with health status and wellbeing

OBJETIVOS: Determinar los modelos predictivos que incluyan las dimensiones del burnout predictoras de la salud física/mental y del bienestar subjetivo/psicológico percibido en profesionales de intensivos; analizar las relaciones entre el síndrome de burnout, la salud y el bienestar percibido por dichos profesionales; y establecer las diferencias sociodemográficas en las variables evaluadas. MÉTODO: Se llevó a cabo un estudio correlacional de corte trasversal. Participaron un total de 52 profesionales de intensivos, principalmente enfermeras, de una unidad de cuidados intensivos de Madrid. Todos los participantes fueron evaluados mediante los cuestionarios Maslach Burnout Inventory-Human Services Survey, Short Form-12 Health Survey, Satisfaction With Life Scale, Positive and Negative Affect Schedule y Psychological Well-Being Scales. RESULTADOS: No se encontraron diferencias sociodemográficas significativas. Los altos niveles en las tres dimensiones del burnout estuvieron asociados con una pobre salud física/mental y bienestar subjetivo/psicológico. Las altas puntuaciones en agotamiento emocional y despersonalización y bajas en realización personal predijeron negativamente las escalas del bienestar subjetivo y psicológico. La escala de autoaceptación obtuvo la mayor validez predictiva. El agotamiento emocional fue la única dimensión del burnout que predijo negativamente la salud física y mental. CONCLUSIONES: La salud y el bienestar pueden estar afectados negativamente por el síndrome de burnout de los profesionales de intensivos. Como resultado, es necesaria la implantación de programas para prevenir y tratar este síndrome. Estas intervenciones preventivas no solamente pueden influir positivamente en la salud y bienestar de estos profesionales, sino que también pueden mejorar la práctica clínica, la calidad de la atención y los cuidados prestados y la seguridad del paciente y reducir los costes económicos de las instituciones sanitarias. Por lo tanto, es imperativo implementar programas preventivos dirigidos a los profesionales de intensivos desde las universidades hasta las instituciones sanitarias

OBJECTIVES: To determine the predictive models that include the dimensions of burnout that are predictors for physical/mental health, and subjective/psychological wellbeing perceived in intensive care professionals; to analyse the relationships between burnout syndrome, health status and wellbeing experienced by these professionals; and to establish sociodemographic differences in the variables evaluated. METHOD: A correlational and cross-sectional study was conducted. A total of 52 critical care professionals, mainly nurses, were recruited from an intensive care unit of Madrid. All participants were assessed with the questionnaires: Maslach Burnout Inventory-Human Services Survey, Short Form-12 Health Survey, Satisfaction With Life Scale, Positive and Negative Affect Schedule, and Psychological Well-Being Scales. RESULTS: No significant sociodemographic differences were found. High levels in the three burnout dimensions were associated with poor physical/mental health and subjective/psychological wellbeing. High scores in emotional exhaustion and depersonalization, and low in personal accomplishment negatively predicted subjective and psychological well-being scales. The self-acceptance scale had the highest predictive validity. Emotional exhaustion was the only burnout dimension that negatively predicted physical and mental health. CONCLUSIONS: Health status and levels of subjective/psychological wellbeing can be negatively influenced by the burnout syndrome experienced by intensive care professionals. As a result, the implementation of programmes to prevent and treat this syndrome is needed. These preventive interventions can positively impact not only the health and wellbeing of these professionals, but can also improve their ability to practice effectively, improve healthcare quality and patient security, and reduce the economic costs of health institutions. It is therefore imperative to implement burnout preventive programmes for intensive care professionals from universities to health institutions

Alimentación por sonda pospilórica versus sonda gástrica para la prevención de la neumonía y la mejora de los resultados nutricionales en adultos en estado crítico / Post-pyloric versus gastric tube feeding for preventing pneumonia and improving nutritional outcomes in critically ill adults

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Burnout syndrome in intensive care professionals: relationships with health status and wellbeing. / Síndrome de burnout en los profesionales de cuidados intensivos: relaciones con la salud y el bienestar.

OBJECTIVES: To determine the predictive models that include the dimensions of burnout that are predictors for physical/mental health, and subjective/psychological wellbeing perceived in intensive care professionals; to analyse the relationships between burnout syndrome, health status and wellbeing experienced by these professionals; and to establish sociodemographic differences in the variables evaluated. METHOD: A correlational and cross-sectional study was conducted. A total of 52 critical care professionals, mainly nurses, were recruited from an intensive care unit of Madrid. All participants were assessed with the questionnaires: Maslach Burnout Inventory-Human Services Survey, Short Form-12 Health Survey, Satisfaction With Life Scale, Positive and Negative Affect Schedule, and Psychological Well-Being Scales. RESULTS: No significant sociodemographic differences were found. High levels in the three burnout dimensions were associated with poor physical/mental health and subjective/psychological wellbeing. High scores in emotional exhaustion and depersonalization, and low in personal accomplishment negatively predicted subjective and psychological well-being scales. The self-acceptance scale had the highest predictive validity. Emotional exhaustion was the only burnout dimension that negatively predicted physical and mental health. CONCLUSIONS: Health status and levels of subjective/psychological wellbeing can be negatively influenced by the burnout syndrome experienced by intensive care professionals. As a result, the implementation of programmes to prevent and treat this syndrome is needed. These preventive interventions can positively impact not only the health and wellbeing of these professionals, but can also improve their ability to practice effectively, improve healthcare quality and patient security, and reduce the economic costs of health institutions. It is therefore imperative to implement burnout preventive programmes for intensive care professionals from universities to health institutions.

A propósito de los modelos de ecuaciones estructurales y la evaluación de los índices de ajuste / As regards structural equation models and the evaluation of fit indices

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Recursos personales relevantes para el bienestar psicológico en el personal de enfermería / Personal resources relevant to psychological well-being in nursing

Objetivos: Determinar las diferencias en apoyo social, resiliencia, afrontamiento y bienestar psicológico (BP) entre los profesionales de enfermería de intensivos y de otros servicios hospitalarios; y establecer un modelo estructural en el que se incluyan los recursos personales relevantes para el BP de dichos profesionales. Método: Estudio correlacional de tipo transversal. Participó una muestra de 208 profesionales de enfermería del Hospital Universitario de Fuenlabrada (Madrid), formada por enfermeros/as (n = 133), auxiliares (n = 61) y matronas (n = 14), de los cuales 44 pertenecían a intensivos, 50 a otros servicios especiales y 114 a servicios de hospitalización. Instrumentos: Subescala de Apoyo Social, 10-Item CD-RISC (resiliencia), Brief-Cope (afrontamiento), Scales of Psychological Well-being (BP) y variables sociodemográficas. Resultados: No se encontraron diferencias en ninguna de las variables psicológicas evaluadas en función del servicio hospitalario. El modelo estructural encontrado mostró que el apoyo social, la resiliencia y el afrontamiento determinaron el BP en el personal de enfermería. El recurso personal más importante fueron las estrategias de afrontamiento que determinó directamente (Beta = 0,68) el BP. El apoyo social influyó directa (Beta = 0,33) e indirectamente (Beta = 0,32) en el BP, mientras que la resiliencia influyó indirectamente (Beta = 0,57). Conclusiones: Las diferencias en BP, afrontamiento, apoyo social y resiliencia no están determinadas por el servicio hospitalario. Las estrategias de afrontamiento de compromiso (o adaptativo), el apoyo social y la resiliencia constituyen tres recursos personales relevantes que determinan el BP del personal de enfermería y que se pueden desarrollar y mejorar mediante programas específicos. Las dimensiones del BP más importantes son autoaceptación y dominio del entorno

Aims: To determine differences in social support, resilience, coping, and psychological well-being (PWB) among intensive care nursing and nursing staff of other hospital services, as well as to establish a structural model in these professionals where relevant personal resources to PWB were included. Method: Correlational and cross-sectional study. A sample of 208 nursing professionals from University Hospital of Fuenlabrada (Madrid) took part in the study. This sample consisted of nurses (n = 133), nursing assistants (n = 61), and midwives (n = 14), of whom 44 worked in intensive care unit, 50 in other special units, and 114 in wards. Instruments: Social Support Subscale, 10-Item CD-RISC (resilience), Brief-Cope (coping), Scales of PWB, and sociodemographic variables. Results: No differences were found in any assessed psychological variables as regards hospital service worked in. A structural model was found and showed that social support, resilience, and coping determined PWB of nursing professionals. The most important personal resource was coping strategies, which determined PWB directly (Beta = 0.68). Social support influenced PWB directly (Beta = 0.33), and indirectly (Beta = 0.32), whereas resilience influenced it indirectly (Beta = 0.57). Conclusions: Differences in PWB, coping, social support and resilience are not determined by hospital service. Coping strategies focused on engagement (or adaptive), social support, and resilience, constitute three relevant personal resources that determine the PWB of nursing staff, which can be developed and improved by specific programs. The most important PWB dimensions are self-acceptance and environment mastery

[Personal resources relevant to psychological well-being in nursing]. / Recursos personales relevantes para el bienestar psicológico en el personal de enfermería.

AIMS: To determine differences in social support, resilience, coping, and psychological well-being (PWB) among intensive care nursing and nursing staff of other hospital services, as well as to establish a structural model in these professionals where relevant personal resources to PWB were included. METHOD: Correlational and cross-sectional study. A sample of 208 nursing professionals from University Hospital of Fuenlabrada (Madrid) took part in the study. This sample consisted of nurses (n=133), nursing assistants (n=61), and midwives (n=14), of whom 44 worked in intensive care unit, 50 in other special units, and 114 in wards. INSTRUMENTS: Social Support Subscale, 10-Item CD-RISC (resilience), Brief-Cope (coping), Scales of PWB, and sociodemographic variables. RESULTS: No differences were found in any assessed psychological variables as regards hospital service worked in. A structural model was found and showed that social support, resilience, and coping determined PWB of nursing professionals. The most important personal resource was coping strategies, which determined PWB directly (ß=0.68). Social support influenced PWB directly (ß=0.33), and indirectly (ß=0.32), whereas resilience influenced it indirectly (ß=0.57). CONCLUSIONS: Differences in PWB, coping, social support and resilience are not determined by hospital service. Coping strategies focused on engagement (or adaptive), social support, and resilience, constitute three relevant personal resources that determine the PWB of nursing staff, which can be developed and improved by specific programs. The most important PWB dimensions are self-acceptance and environment mastery.

El bienestar subjetivo percibido por los profesionales no sanitarios ¿es diferente al de enfermería de intensivos? Relación con personalidad y resiliencia / Is subjective well-being perceived by non-health care workers different from that perceived by nurses? Relation with personality and resilience

El bienestar subjetivo (BS), denominado comúnmente «felicidad», se ve afectado directamente por factores psicológicos. Entre ellos se incluyen la personalidad y la resiliencia (capacidad de sobreponerse a la adversidad). La evidencia empírica ha demostrado que la resiliencia es una característica esencial e inherente al personal de enfermería. Este estudio está dirigido a analizar los factores de personalidad (incluyendo la resiliencia) que se relacionan con el BS (satisfacción con la vida, afecto positivo y negativo) en una muestra de personal de enfermería (n = 59) de intensivos y cardiología, y otra de personal no sanitario (n = 50) formada por funcionarios y profesores principalmente. Los análisis de regresión múltiple mostraron que el BS estaba asociado con una mayor resiliencia y un menor neuroticismo en el personal de enfermería. La extraversión y el tesón (relacionados positivamente) y el neuroticismo (negativamente relacionado) fueron los predictores significativos del BS en el personal no sanitario. Finalmente, los análisis mediacionales revelaron que la resiliencia medió las relaciones entre la extraversión (mediación total) y el neuroticismo (mediación parcial) con el BS en los profesionales de enfermería, pero no en el personal no sanitario. Los resultados ponen de manifiesto la importancia de la resiliencia en el personal de enfermería de intensivos, expuestos constantemente al sufrimiento humano y a un continuo entorno laboral adverso. Asimismo se subraya que la resiliencia es un medio para que la enfermería afronte el estrés asociado con su trabajo y que las enfermeras resilientes son un elemento crucial en nuestro sistema sanitario (AU)

Subjective well-being (SWB), usually called ‘happiness’, is influenced directly by psychological factors. Personality and resilience (capacity of recover from adversity) are included among these factors. Empirical evidence has demonstrated that resilience is an essential and inherent characteristic for the nursery staff. This study has aimed to analyze personality factors (including resilience) related with SWB (satisfaction with life, positive and negativeaffect) in a nursery staff sample (n = 59) of intensive care and cardiological units, and a nonhealth care workers sample (n = 50) mainly made up of government employees and teachers. Multiple regression analyses showed that SWB was associated with more resilience and less neuroticism in the nursery staff. Extraversion and conscientiousness (positively related), and neuroticism (negatively related) were the significant predictors of SWB in the non-health care workers group. Finally, mediational analyses revealed that resilience measured the relations hips between extraversion (total mediation) and neuroticism (partial mediation) with SWB in the nursery staff group, but not in the group of non-health care workers. The results show the importance of resilience for nursery staff of intensive care units, since they are constantly exposed to human suffering and to a continually adverse occupational environment. Likewise, the discussion stresses that resilience is a means for nursing staff to cope with the occupational stress and that resilient nurses are a crucial element in our health care system (AU)

[Is subjective well-being perceived by non-health care workers different from that perceived by nurses? Relation with personality and resilience]. / El bienestar subjetivo percibido por los profesionales no sanitarios ¿es diferente al de enfermería de intensivos? Relación con personalidad y resiliencia.

Subjective well-being (SWB), usually called 'happiness', is influenced directly by psychological factors. Personality and resilience (capacity of recover from adversity) are included among these factors. Empirical evidence has demonstrated that resilience is an essential and inherent characteristic for the nursery staff. This study has aimed to analyze personality factors (including resilience) related with SWB (satisfaction with life, positive and negative affect) in a nursery staff sample (n=59) of intensive care and cardiological units, and a non-health care workers sample (n=50) mainly made up of government employees and teachers. Multiple regression analyses showed that SWB was associated with more resilience and less neuroticism in the nursery staff. Extraversion and conscientiousness (positively related), and neuroticism (negatively related) were the significant predictors of SWB in the non-health care workers group. Finally, mediational analyses revealed that resilience measured the relationships between extraversion (total mediation) and neuroticism (partial mediation) with SWB in the nursery staff group, but not in the group of non-health care workers. The results show the importance of resilience for nursery staff of intensive care units, since they are constantly exposed to human suffering and to a continually adverse occupational environment. Likewise, the discussion stresses that resilience is a means for nursing staff to cope with the occupational stress and that resilient nurses are a crucial element in our health care system.